Salient, age-related issues of development (Sroufe 2013):
Infancy
Major issue: formation of an effective attachment
Additional issues:
- Basic state and arousal regulation
- Development of reciprocity
- Dyadic regulation of emotion
Toddler period
Major issue: guided self-regulation
Additional issues:
- Increased autonomy
- Increases awareness of self and others
- Awareness of standards of behavior
- Self-conscious emotion
Preschool period
Major issue: self-regulation
Additional issues:
- Self-reliance with support (agency)
- Self-management
- Expanding social world
- Internalization of rules and values
School years
Major issue: competence
Additional issues:
- Personal efficacy
- Self-integration
- Competence with peers
- Competence in school
Adolescents
Major issue: individuation
Additional issues:
- Autonomy with connectedness
- Identity
- Peer network competence
- Coordinating school, work and social life
Transition to adulthood
Major issue: emancipation
Additional issues:
- Launching a life course
- Financial responsibility
- Adult social competence
- Coordination work, training, career and life
,The common descriptions of normality and psychopathology often focus on:
1) Statistical deviance: the infrequency of certain emotions, cognitions and/or
behaviors.
2) Sociocultural norms: the beliefs and expectations of certain groups about what kinds
of emotions, cognitions and/or behaviors are undesirable or unacceptable.
3) Mental health perspective: theoretical or clinical based notions of distress and
dysfunction. The landmark report of the U.S sergeon general (2000) states that
‘mentally healthy children and adolescents enjoy a positive quality of life: function
well at home, in school, and in their communities: and are free of disabling symptoms
of psychopathology.
The role of values:
Poor adaptation:
Adequate adaptation: has to do with what is considered oke, acceptable or good enough.
Optimal adaptation: has to do with what is excellent, superior or the best of what is possible.
Brazelton and Greenspan have described essential needs for children (2000).
The need for ongoing nurturing relationships
The need for physical protection, safety and regulation
The need for experiences tailored to individual difference
The need for developmentally appropriate experiences
The need for limit setting, structure and expectations
The need for stable, supportive communities and cultural continuity.
In our descriptions and discussions of children’s disorders, we will refer repeatedly to
prevention and intervention strategies that are bases on these needs.
The impact of values on definitions of disorder (de impact van waardes op definities van een
stoornis):
1) Statistical deviance definitions: it sometimes makes sense to examine both extremes
of the continuum, because we have made a judgement that there is a desirable
middle course related to the characteristic in question. At other times it makes sense
to focus only on the ‘bad’ end of the continuum and ignore the ‘good’ end. In these
specific cases, judgements are made that some types of extreme characteristics are
to be accepted or even prized.
2) Sociocultural definitions, value judgements are the very basis of definitions of
disorder. Whether casual use of mind-altering substances is tolerated or condemned
by a particular sociocultural group influences conceptualizations of pathological
addiction.
3) Mental health definitions, the values of psychologists, psychiatrists and clinical social
workers are embedded in both scientific and lay community decision making.
Clinicians must evaluate whether a young person’s life is characterized by a positive
quality, adequate functioning and few symptoms.
Value judgements are the basis of sociocultural definitions of disorder.
Psychopathology refers to intense, frequent, and/or persistent maladaptive patterns of
emotion, cognition and behavior.
, Developmental psychopathology extends this description to empathize that these
maladaptive patterns occur in the context of typical development and result in the current
and potential impairment of infants, children and adolescents.
Rates of disorder in infancy, childhood and adolescents:
The multipart task of estimating rates of disorder includes:
1) Identifying children with clinically significant distress and disfunction, whether or not
they are in treatment.
2) Calculating levels of general and specific psychopathologies and the impairments
associated with various disorders.
3) Tracking changing trends in the identification and diagnosis of specific categories of
disorders.
Prevalence and incidence rates are both measures of the frequency of pathology
Prevalence refers to the proportion of a population with a disorder (all current cases of the
disorder).
Incidence refers to the rate at which new cases arise (all new cases in a given time period).
Recent data from the National Health and Nutrition Examination Study estimate that 13% of
children between 8 and 15 years in the United States met the criteria for any disorder.
Barriers to care are widespread and have been extensively summarized.
Structural barriers include limited policy perspectives, disjoined systems, lack of
provider availability, long waiting lists, inconveniently located services, transportation
difficulties and inability to pay and/or inadequate insurance coverage.
Barriers related to perceptions about mental health difficulties include the inability
to acknowledge a disorder, denial of problem severity, and beliefs that difficulties will
resolve over time or will improve without formal treatment.
Barriers related to perceptions about mental health services involve a lack of thrust
in the system, previous negative experiences and the stigma related to seeking help.
Tolan and Dodge (2005) propose a four-part model for a comprehensive system that
simultaneously promotes mental health within normal developmental settings, provides aid
for emerging mental health issues for children, targets high-risk youth with prevention and
provides effective treatment for disorders:
1) Children and their families should be able to access appropriate and effective mental
health services directly
2) Child mental health should be a major component of healthy development
promotion and attention in primary care settings like schools.
3) Efforts should empathize preventive care for high-risk children and families.
4) More attention must be paid to cultural context and cultural competence.
Stigmatization
A final issue concerns the continued and painfully unnecessary stigmatization of individuals
with psychopathology. Lack of respect of lack of access to care are often the results of
personal, familial, social and institutional stigmas.
Infancy
Major issue: formation of an effective attachment
Additional issues:
- Basic state and arousal regulation
- Development of reciprocity
- Dyadic regulation of emotion
Toddler period
Major issue: guided self-regulation
Additional issues:
- Increased autonomy
- Increases awareness of self and others
- Awareness of standards of behavior
- Self-conscious emotion
Preschool period
Major issue: self-regulation
Additional issues:
- Self-reliance with support (agency)
- Self-management
- Expanding social world
- Internalization of rules and values
School years
Major issue: competence
Additional issues:
- Personal efficacy
- Self-integration
- Competence with peers
- Competence in school
Adolescents
Major issue: individuation
Additional issues:
- Autonomy with connectedness
- Identity
- Peer network competence
- Coordinating school, work and social life
Transition to adulthood
Major issue: emancipation
Additional issues:
- Launching a life course
- Financial responsibility
- Adult social competence
- Coordination work, training, career and life
,The common descriptions of normality and psychopathology often focus on:
1) Statistical deviance: the infrequency of certain emotions, cognitions and/or
behaviors.
2) Sociocultural norms: the beliefs and expectations of certain groups about what kinds
of emotions, cognitions and/or behaviors are undesirable or unacceptable.
3) Mental health perspective: theoretical or clinical based notions of distress and
dysfunction. The landmark report of the U.S sergeon general (2000) states that
‘mentally healthy children and adolescents enjoy a positive quality of life: function
well at home, in school, and in their communities: and are free of disabling symptoms
of psychopathology.
The role of values:
Poor adaptation:
Adequate adaptation: has to do with what is considered oke, acceptable or good enough.
Optimal adaptation: has to do with what is excellent, superior or the best of what is possible.
Brazelton and Greenspan have described essential needs for children (2000).
The need for ongoing nurturing relationships
The need for physical protection, safety and regulation
The need for experiences tailored to individual difference
The need for developmentally appropriate experiences
The need for limit setting, structure and expectations
The need for stable, supportive communities and cultural continuity.
In our descriptions and discussions of children’s disorders, we will refer repeatedly to
prevention and intervention strategies that are bases on these needs.
The impact of values on definitions of disorder (de impact van waardes op definities van een
stoornis):
1) Statistical deviance definitions: it sometimes makes sense to examine both extremes
of the continuum, because we have made a judgement that there is a desirable
middle course related to the characteristic in question. At other times it makes sense
to focus only on the ‘bad’ end of the continuum and ignore the ‘good’ end. In these
specific cases, judgements are made that some types of extreme characteristics are
to be accepted or even prized.
2) Sociocultural definitions, value judgements are the very basis of definitions of
disorder. Whether casual use of mind-altering substances is tolerated or condemned
by a particular sociocultural group influences conceptualizations of pathological
addiction.
3) Mental health definitions, the values of psychologists, psychiatrists and clinical social
workers are embedded in both scientific and lay community decision making.
Clinicians must evaluate whether a young person’s life is characterized by a positive
quality, adequate functioning and few symptoms.
Value judgements are the basis of sociocultural definitions of disorder.
Psychopathology refers to intense, frequent, and/or persistent maladaptive patterns of
emotion, cognition and behavior.
, Developmental psychopathology extends this description to empathize that these
maladaptive patterns occur in the context of typical development and result in the current
and potential impairment of infants, children and adolescents.
Rates of disorder in infancy, childhood and adolescents:
The multipart task of estimating rates of disorder includes:
1) Identifying children with clinically significant distress and disfunction, whether or not
they are in treatment.
2) Calculating levels of general and specific psychopathologies and the impairments
associated with various disorders.
3) Tracking changing trends in the identification and diagnosis of specific categories of
disorders.
Prevalence and incidence rates are both measures of the frequency of pathology
Prevalence refers to the proportion of a population with a disorder (all current cases of the
disorder).
Incidence refers to the rate at which new cases arise (all new cases in a given time period).
Recent data from the National Health and Nutrition Examination Study estimate that 13% of
children between 8 and 15 years in the United States met the criteria for any disorder.
Barriers to care are widespread and have been extensively summarized.
Structural barriers include limited policy perspectives, disjoined systems, lack of
provider availability, long waiting lists, inconveniently located services, transportation
difficulties and inability to pay and/or inadequate insurance coverage.
Barriers related to perceptions about mental health difficulties include the inability
to acknowledge a disorder, denial of problem severity, and beliefs that difficulties will
resolve over time or will improve without formal treatment.
Barriers related to perceptions about mental health services involve a lack of thrust
in the system, previous negative experiences and the stigma related to seeking help.
Tolan and Dodge (2005) propose a four-part model for a comprehensive system that
simultaneously promotes mental health within normal developmental settings, provides aid
for emerging mental health issues for children, targets high-risk youth with prevention and
provides effective treatment for disorders:
1) Children and their families should be able to access appropriate and effective mental
health services directly
2) Child mental health should be a major component of healthy development
promotion and attention in primary care settings like schools.
3) Efforts should empathize preventive care for high-risk children and families.
4) More attention must be paid to cultural context and cultural competence.
Stigmatization
A final issue concerns the continued and painfully unnecessary stigmatization of individuals
with psychopathology. Lack of respect of lack of access to care are often the results of
personal, familial, social and institutional stigmas.
